Sequential Endoscopic Lung Volume Reduction

Sequential Endoscopic Lung Volume Reduction in Patients With Heterogeneous Lung Emphysema

Patients with heterogenous emphysema benefits from endoscopic lung volume reduction. Until now the technique is limited to one lobe. In case of collateral ventilation patients show no improvement. Between upper and middle lobe exists the highest collateral flow. The trial examine the hypothesis, that sequential ELVR help especially those patients, which have no benefit after lobar exclusion.

Patients with heterogenous emphysema undergo ELVR, target lobe is the upper lobe right. After 6 weeks the middle lobe will be block too.

Follow-up period 6 months Primary end points: FEV 1, 6-Minute walk test Secondary endpoints. Safety, Symptom scores Number of patients planned 30

Inclusion Criteria:

• Heterogenous emphysema
• FEV1 < 45%
• RV > 150%
• TLC > 100%
• TLCO < 40%

Exclusion Criteria:

• Homogeneous emphysema
• Pregnancy
• PCO2 > 50 mmHg